The diagnosis of cancer is embedded in the negative social discourse of a death sentence. It therefore creates an existential crisis in the lives of its victims. This article will explore the pastoral implications of a cancer diagnosis. Whereas the medical path becomes clear upon the diagnosis of a particular type of cancer, the pastoral path may not immediately be evident. By viewing cancer phenomologically and in the light of the most common medical treatment, the article will try to establish what key issues (changes) would be brought upon persons affected by cancer. Eight key issues are taken into consideration: the change of short and long-term goals, the exposure to new relationships, feelings of rejection, an identity crisis, a radicalisa-tion of communication, a new perspective on time, death-anxiety and faith issues. In the light of these anticipated key issues, six focus areas are identified as preliminary markers for the pastoral process. The problem of theodicy, suffering, the relationship between sin and illness, ethical issues of a medical nature, end of life counselling and eschatological perspectives are taken into consideration as areas that would be of great value in the pastorate to persons affected by cancer.

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